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No jab, no job: Essential patient protection, or staffing disaster?

The UK government’s consultation on mandatory vaccination for social care staff has finally reported that a “no jab, no job” policy will soon be in place. Is this a necessary step to restore confidence in a sector badly damaged by Covid or a major risk to staffing in a sector that has always struggled with recruitment and retention?

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In Italy, where a mandatory vaccine policy has been introduced, vaccine hesitancy is more prevalent than elsewhere in Europe. Despite this, HBI has not heard of major job losses in the sector though these may take time to filter through. Discussion of a similar imposition elsewhere in Europe has been rife. France actively considered its position and while Israel did not make it mandatory, it made carers aware that a decision not to vaccinate would be recorded and this could impact their careers.

It is in the UK where this is currently grabbing headlines, however. From October, subject to Parliamentary approval, new legislation will mean care home staff have sixteen weeks to have the jab or face being re-deployed from the frontline or possibly lose their job.

The argument for a mandatory vaccine is clear from an operator’s perspective. According to a 2020 Knight Frank report care home occupancy in the UK fell from 87.9% in 2019 to 79.4% in the second quarter of 2020. Having fully vaccinated staff will help restore confidence in people considering entering nursing homes and hopefully mean lost occupancy can be recovered faster. Large groups such as Barchester and Care-One already introduced “no jab no job” policies prior to the mandatory vaccine consultation even beginning.

Predictably, others have disagreed. Mike Padgham, chair of the Independent Care Group, that represents smaller operators, says: “This will without doubt create another barrier to recruitment at a time when social care providers are facing an employment crisis and struggling to fill one shift at a time.” On top of this it has been speculated, by the GMB trade union, that this move may lead to the loss of as many as a third of social care staff. Indeed, it impossible to see how a small care home group or a family run home will be able to re-deploy staff from the frontline, there is nowhere to redeploy them to, refuseniks will have to go.

Given the risk of major staff losses to a sector that already struggles with retention, it is a bold position the government has taken. With the retail and hospitality sectors now open and most lockdown restrictions expected to be ditched on July 21, there should be opportunity for disgruntled care workers to jump ship and more easily find work in another sector. Most care home workers in the UK are not fully trained nurses who have committed to a medical career, but less medicalised carers who earn about half of a nurse’s salary, usually receiving only slightly above the National Living Wage.

However, given that as of June 6, 84% of UK care home staff had received one dose with 69% receiving two jabs, the suggestion that the care home sector could lose 20-30% of its staff seems overblown. We have heard from a lot of care home operators that they had an easier time with recruitment during the pandemic, as the retail sector collapsed. How many of these staff will want to stay in an underfunded sector, doing a very difficult job, when the promise of a far less stressful job in a restaurant or hotel is just an application away? The introduction of a mandatory vaccination could easily push many newer staff to leave the sector.

It is understandable that, while smaller operators do support the vaccination rollout, they are angered by the decision to force staff to take the vaccine – particularly from a government that has largely ignored their sector despite Covid having pushed it into the spotlight. The decision of the Chancellor, Rishi Sunak, to completely ignore the social care sector in his March budget was taken as a slap in the face by a sector that had taken a massive hit from Covid in the preceding months. In part due to government failures in sending Covid infected hospital patients into nursing homes without testing them.

Fundamentally, it seems unlikely that the worst predictions of staff losses will come true. That said, the idea that some staff may be pushed into jumping to the growing retail sector by the mandatory vaccination seems plausible. The report published yesterday by the Public Accounts Committee said that due to the pandemic many providers were at risk of failing and fairly chastised the government that despite all its “white papers, green papers, consultations, independent reviews and commissions”, as yet, “reform has not occurred.”

If the “no jab no job” policy does lead to staff losses and puts operators at risk of failing, the government cannot say it was not warned – and no doubt it knows this. But the alternative, further preventable deaths linked to a missed precautionary step, may be even less palatable.


We would welcome your thoughts on this story. Email your views to James Elliott or call 0207 183 3779.